Evidence map›Paper›PMID 42068362›Full record

ArticleNeuroradiology2026

Efficacy and safety of bridging intravenous thrombolysis prior to endovascular treatment in patients over 80 years old with acute ischemic stroke.

Yimin Chen, Isabel Siow, Keng Siang Lee, Qibei Dai, Xiao Xiao, Apar Garg, Anil Gopinathan, Cunli Yang, Benjamin Tan, Mingxue Jing and 16 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Yimin Chen *Department of Neurology, Nanfang Hospital,Southern Medical University, Guangzhou, China.
Isabel Siow *Department of Neurology, National Neuroscience Institute, Singapore, Singapore.
Keng Siang Lee *Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
Qibei DaiDepartment of Neurology, Nanfang Hospital,Southern Medical University, Guangzhou, China.
Xiao XiaoDepartment of Medicine, National University Health System, Singapore, Singapore.
Apar GargDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Anil GopinathanDepartment of Diagnostic Radiology, National University Health System, Singapore, Singapore.
Cunli YangDepartment of Radiology, Woodlands Health Campus, Singapore, Singapore.
Benjamin TanDivision of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
Mingxue JingDivision of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
May ZinDivision of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
Hock Luen TeohDivision of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
Ching Hui SiaDivision of Cardiology, Department of Medicine, National University Health System, Singapore, Singapore.
Mingzhu FengDepartment of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, Foshan, China.
Jicai MaDepartment of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, China.
Lue ChenDepartment of Neurology, The Eighth Affiliated Hospital of Southern Medical University, Foshan, China.
Sijie ZhouDepartment of Surgery of Cerebrovascular Diseases, First People's Hospital of Foshan, Foshan, China.
Zunbao XuNeuromedical Center Ward 2, The Affiliated Panyu Central Hospital, Guangzhou Medical University, Guangzhou, China.
Yongting ZhouDepartment of Neurology, Huadu District People's Hospital of Guangzhou, Huadu, China.
Yuzheng LaiDepartment of Neurology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China.
Wenhong PengDepartment of Neurology and Advanced National Stroke, Shaoguan First People's Hospital, Shaoguan, China.
Yihua HeDepartment of Neurology, Nanfang Hospital,Southern Medical University, Guangzhou, China.
Mohammad MofattehSchool of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Thanh NguyenDepartment of Neurology, Boston University, Boston, USA.
Suyue Pan *Department of Neurology, Nanfang Hospital,Southern Medical University, Guangzhou, China. pansuyue@smu.edu.cn.
Leonard Yeo *Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore. leonard_ll_yeo@nuhs.edu.sg.

Funding

National Medical Research Council NMRC MOH-001461Yong Loo Lin School of Medicine, National University of Singapore No.202409310004
6 · The paper itself

Abstract

introductionEndovascular treatment (EVT) is an effective treatment for patients with acute ischemic stroke (AIS); however, it remains to be determined if treatment with intravenous thrombolysis (IVT) prior to EVT confers any benefit in octogenarians and older. This study aimed to address if bridging tPA has improved functional outcomes or complications in patients 80 years and older.

methodsThis multicentre retrospective cohort study included patients 80 years old and above who underwent endovascular therapy for large vessel occlusion acute ischaemic stroke in 10 compressive stroke centres across China and Singapore between 2018 and 2024. Clinical and procedural factors of patients in Singapore and China were compared using multivariate binary logistic regression. The primary outcome measured was 3-month functional independence defined as modified rankin scale (mRS) 0-2. Secondary outcomes included 3-month independent ambulation as defined as mRS 0-3, 3-month mortality rates and achieving successful recanalization. Data on intracranial haemorrhage was also collected.

resultsBridging IVT was not associated with improvement in 3-month functional independence (24.47% vs. 20.97%; p = 0.505), improvement in 3-month independent ambulation (32.80% vs. 41.49%; p = 0.512), 3-month mortality rates (36.17% vs. 33.33%; p = 0.637) or increased rates of successful recanalisation (89.36% vs. 87.63%; p = 0.672),. Instead, patients who underwent bridging IVT had higher rates of haemorrhage compared to patients who did not undergo bridging IVT even after adjusting for confounding factors (OR = 1.921; 95% CI 1.026-3.596; p = 0.041).

conclusionThe findings of this study suggest that bridging IVT prior to EVT may not improve functional outcomes or mortality rates. However, it appears to be associated with an increase in risk of intracranial haemorrhage.

Indexed as

Endovascular ProceduresFibrinolytic AgentsIschemic StrokeThrombolytic TherapyTissue Plasminogen ActivatorAged, 80 and overBridge TherapyChinaFemaleHumansMaleRetrospective StudiesSingaporeTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorElderlyIntravenous thrombolysisStroke

Identifiers

PMID42068362

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.